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But Trans Bili should only be used when babies are 35 weeks or more and are therefore unlikely to weigh 1000g. Moreover, when was the last time we needed to get 8ml of blood to check a bili? ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Reynolds Tim Sent: 06 September 2010 17:12 To: [log in to unmask] Subject: Re: Neonatal Jaundice Because taking blood samples from neonates causes significant pain and iatrogenic blood loss. If these can be avoided to a large extent this is of benefit to the infant. For a 1000g fetus, 8mL of blood is the equivalent of 1 pint blood loss from an adult. 60% of the most painful procedures applied to neonates are related to collecting samples. Neurobehavioral studoes show that these stimuli have a long-lasting effect on the responses to stimuli of oinfamts that have been on a NNU. ************************************************************************ ************** Prof. Tim Reynolds Consultant Chemical Pathologist Burton Hospitals NHS Foundation Trust work tel: 01283 511511 ext 4035 work fax: 01283 593064 work email: [log in to unmask] home email: [log in to unmask] work URL: www.burtonhospitals.nhs.uk This e-mail, and any files transmitted with it, are confidential and intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient please destroy this message, delete any copies held on your systems, and notify the sender immediately. You should not retain copy or use this e-mail for any purpose, nor disclose all or any part of its content to any other person. If you have received this e-mail in error, please notify me on 01283 511511 Ext 4035 [Picture of tree not available] Please consider the environment before printing this e-mail This corporate email signature and disclaimer is now a Trust requirement. This has been enforced by Deborah Price, Acting Director of Corporate Development and Helen Ashley, Chief Executive. -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Ian Barlow Sent: 06 September 2010 17:03 To: [log in to unmask] Subject: Re: Neonatal Jaundice Why do we waste precious NHS resources on equipment that provides an inferior test result, (is recommended to be checked by the lab), and does not need to be done with critical urgency? Ian ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Kay Sent: 06 September 2010 16:09 To: [log in to unmask] Subject: Re: Neonatal Jaundice Yes, we're buying lots of transcutaneous bilirubinometers. Unfortunately it looks as if the first tranche won't have computerised communications available. Does any one have a project or system that does? (Our guess is that the CLT workload will initially go up, then go down... ) Jonathan On 6 Sep 2010, at 15:55, O'Connor John (Royal Devon and Exeter Foundation Trust) wrote: Dear Collective Are labs following the recently published guideline on neonatal jaundice published in May this year? Quite interesting that TC Bilirubin seems to be first line choice of measurement BW John http://www.nice.org.uk/nicemedia/live/12986/48678/48678.pdf * use a transcutaneous bilirubinometer in babies with a gestational age of 35 weeks or more and postnatal age of more than 24 hours * if a transcutaneous bilirubinometer is not available, measure the serum bilirubin * if a transcutaneous bilirubinometer measurement indicates a bilirubin level greater than 250 micromol/litre check the result by measuring the serum bilirubin * always use serum bilirubin measurement to determine the bilirubin level in babies with jaundice in the first 24 hours of life * always use serum bilirubin measurement to determine the bilirubin level in babies less than 35 weeks gestational age * always use serum bilirubin measurement for babies at or above the relevant treatment threshold for their postnatal age, and for all subsequent measurements * do not use an icterometer. The important bit is at the end Research recommendation What is the comparative accuracy of the Minolta JM-103 and the BiliChek when compared to serum bilirubin levels in all babies? Why this is important Evidence: The accuracy of transcutaneous bilirubinometers (Minolta JM-103 and BiliChek) has been adequately demonstrated in term babies below treatment levels (bilirubin < 250 micromol/litre). New research is needed to evaluate the accuracy of different transcutaneous bilirubinometers in comparison to serum bilirubin levels in all babies. Population: Babies in the first 28 days of life. Subgroups to include preterm babies, babies with dark skin tones, babies with high levels of bilirubin and babies after phototherapy. Exposure: Bilirubin levels taken from different transcutaneous bilirubinometers. Comparison: Bilirubin levels assessed using serum (blood) tests. Outcome: Diagnostic accuracy (sensitivity, specificity, positive predictive value, negative predictive value), parental anxiety, staff and parental satisfaction with test and cost effectiveness. Time stamp: Sept 2009 ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Workhttp://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/